Chachami G, Hatziefthimiou A, Liakos P, Ioannou MG, Koukoulis GK, Bonanou S, Molyvdas P-A, Simos G, Paraskeva E. Exposure of differentiated airway smooth muscle cells to serum stimulates both induction of hypoxia-inducible factor-1␣ and airway responsiveness to ACh. Am J Physiol Lung Cell Mol Physiol 293: L913-L922, 2007. First published July 27, 2007; doi:10.1152/ajplung.00459.2006.-Airway smooth muscle (ASM) cells are characterized by phenotypic plasticity and can switch between differentiated and proliferative phenotypes. In rabbit tracheal ASM cells that had been differentiated in vitro by serum starvation, readdition of FBS caused initiation of proliferation and induction of nuclear and transcriptionally active hypoxia-inducible factor (HIF)-1␣. In addition, FBS stimulated the induction of HIF-1␣ by the hypoxia mimetic cobalt. Treatment with actinomycin D, cycloheximide, the phosphatidylinositol 3-kinase inhibitors LY-294002 and wortmannin or the reactive oxygen species scavenger diphenyleneiodonium inhibited the FBS-dependent induction of HIF-1␣. These data indicate that, in differentiated ASM cells, FBS upregulates HIF-1␣ by a transcription-, translation-, phosphatidylinositol 3-kinase-, and reactive oxygen species-dependent mechanism. Interestingly, addition of FBS and cobalt also induced HIF-1␣ in organ cultures of rabbit trachea strips and synergistically increased their contractile response to ACh, suggesting that HIF-1␣ might be implicated in airway hypercontractility. cobalt; fetal bovine serum AIRWAY SMOOTH MUSCLE (ASM) cells of trachea and bronchi are important for O 2 homeostasis, since they control the diameter of the airways and regulate the amount of air that reaches the lungs. Smooth muscle cells are not terminally differentiated but retain phenotypic plasticity and switch between contractiledifferentiated and synthetic-proliferative phenotypes with unique morphological, biochemical, functional, and gene expression characteristics (21). Inflammation and injury promote acquisition of the proliferative phenotype and cause hyperplasia and hypertrophy of ASM, which in turn result in airway narrowing (24). These phenotypic changes can be reconstituted in vitro in ASM cell cultures, which have been used to study airway remodeling (19,20). ASM cell proliferation is mainly controlled by the phosphatidylinositol 3-kinase (PI3K) and MAPK pathways (1, 51), which are activated by growth factors present in serum.In ASM, as in most other cell types, cellular proliferation is closely linked to the availability of O 2 . In vitro, O 2 levels are suggested to modulate ASM cell growth, with moderate hypoxia inducing and severe hypoxia inhibiting cell proliferation (10). At the tissue level, chronic hypoxia results in hyperplasia of bronchial smooth muscle (26), increased sensitivity of ASM to cholinergic agonists (3), and epithelium-dependent attenuation of contractile responses in isolated rat trachea, which is reversed on removal of the epithelium (9). Therefore, an interplay appears to exist between the hyp...